Posterior Surgery May Be The Best Option For The Treatment Of Cervical Spondylotic Myelopathy: A Comparative Study In China

The present study was conducted with aims of evaluating the efficacy and safety of three surgical procedures in the treatment of patients with cervical spondylotic myelopathy (CSM). A total of 182 CSM patients were selected and assigned into the anterior surgery group (n = 71), posterior surgery group (n = 55) and anteriorposterior surgery group (n = 56). Various parameters including Pavlov ratio (PR), range of motion (ROM), cervical curvature index (CCI), cord signal change (CSC), Square (S), and incidence of adverse reactions or complications were recorded. Visual analogue scale (VAS) was used to determine the intensity of pain right after surgery and after a period of 3 years. The modified Japanese orthopaedic association scale (mJOA) was employed in order to evaluate the efficacy. The patients in the anterior surgery group presented with a lower incidence of adverse reaction and complications, decreased VAS scores, as well as increased long-term rate of pain relief 3 months after the surgery in comparison with patients in the posterior surgery group and the anterior-posterior surgery group after surgery (p < 0.05). Based on the results of the imaging examination, the imaging indexes among the three groups showed a significant improvement 6 months after surgery as compared to the indexes before surgery (p < 0.05). Furthermore, the anterior surgery group had a higher PR and wider ROM than the other two groups 6 months after surgery (p < 0.05). The aforementioned findings highly indicated that the treatment of CSM with anterior surgery can lead to better efficacy and postoperative results in comparison with posterior surgery or combined anterior-posterior surgery.